18F-Fluoride Imaging: Monitoring Therapy

2019 ◽  
pp. 27-37
Author(s):  
Elba Etchebehere ◽  
Kalevi Kairemo
Keyword(s):  
Monitoring Therapy ◽  
18F Fluoride

[18F]Fluoride PET Indicates Reduced Bone Formation in Severe Glucocorticoid-induced Osteoporosis

1998 ◽  
Vol 37 (02) ◽  
pp. 76-79 ◽  
Author(s):  
T. D. Kirchhoff ◽  
W. Burchert ◽  
J. v. d. Hoff ◽  
H. Zeidler ◽  
H. Hundeshagen ◽  
...  
Keyword(s):  
Bone Formation ◽  
Multiple Organ ◽  
High Dose ◽  
Multiple Fractures ◽  
Glucocorticoid Treatment ◽  
Organ Manifestations ◽  
Diagnostic Benefit ◽  
Sharp Syndrome ◽  
18F Fluoride

SummaryA 61-year-old female patient presenting with mixed connective tissue disease (Sharp syndrome), underwent a long-term high dose glucocorticoid treatment because of multiple organ manifestations. Under steroid therapy she developed severe osteoporosis resulting in multiple fractures. A dynamic [18F]fluoride PET study in this patient revealed reduced fluoride influx in non-fractured vertebrae. This finding corresponds to pathogenetic concepts which propose an inhibition of bone formation as major cause of glucocorticoid-induced osteoporosis. In the light of the presented case it seems to be promising to evaluate the diagnostic benefit of [18F]fluoride PET in osteoporosis.

Editorial [Hot topic: (Part I) Focus on [18F]fluoride Radiochemistry (Guest Editors: D. Roeda, M. Kassiou and F. Dolle)]

2010 ◽  
Vol 3 (2) ◽  
pp. 66-67
Author(s):  
Frederic Dolle ◽  
Michael Kassiou ◽  
Dirk Roeda
Keyword(s):  
18F Fluoride

scholarly journals AB0388 USE OF MESNA PROPHYLAXIS IN CYCLOPHOSPHAMIDE-TREATED PATIENTS WITH ANCA-ASSOCIATED VASCULITIS: RESULTS OF AN ELECTRONIC SURVEY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1222.1-1222
Author(s):  
L. Joos ◽  
S. Gonzalez Chiappe ◽  
T. Neumann ◽  
A. Mahr
Keyword(s):  
Clinical Practice ◽  
Pulse Therapy ◽  
Mesh Term ◽  
Online Information ◽  
Omnibus Test ◽  
Medical Specialties ◽  
Electronic Survey ◽  
Anca Associated Vasculitis ◽  
Monitoring Therapy ◽  
Response Variables

Background:Co-prescribing 2-mercaptoethane sodium sulfonate (mesna) with cyclophosphamide (CYC) for ANCA-associated vasculitis (AAV) aims to prevent the potential urotoxic effects of CYC. The evidence for this practice is often considered weak, and there may be some diversity in what practitioners do in clinical practice.Objectives:To investigate current clinical practice related to prescribing mesna prophylaxis or not and the underlying rationale for CYC-treated patients with AAV.Methods:We searched MEDLINE for publications with the MeSH term “ANCA-associated vasculitis” over a 10-year period up to October 2020. Email addresses of authors of these publications were extracted from the online information available in MEDLINE. These authors were invited by email to participate in an anonymous online SurveyMonkey survey of 21 to 24 questions asking about the characteristics of the respondent, their experience with AAV, and their practice in using CYC to treat AAV and using mesna in CYC-treated patients with AAV and the underlying rationale. Respondents were eligible to take the full survey if they were involved in deciding and/or monitoring therapy with CYC for patients with AAV. We compared 15 response variables to identify factors associated with the use or not of mesna. Response variables with multiple categories were first analyzed across all categories; if the omnibus test result was significant, additional analyses were used to identify the categories, which were the sources of group separation. We analyzed by-country variations for only countries with ≥ 10 respondents. Statistical analyses involved Pearson’s chi-square test or Fisher’s exact test, as appropriate. For multiple-response variables, the Rao-Scott correction was applied.Results:The invitation for the electronic survey was emailed twice in October 2020 to 1,374 unique email addresses; 156 individuals responded; 139 were eligible and completed the survey. The 139 participants were from 34 countries and were essentially MDs (98%) who mainly worked in rheumatology (50%), nephrology (25%) or internal medicine/clinical immunology (18%). Mesna was given in conjunction with CYC systematically, never, or on a case-by-case basis by 68%, 19% and 13% of respondents, respectively. As compared with systematic mesna-prescribers, never/occasional mesna-prescribers reported a longer time since receiving their degree as a health professional (≥ 15 years: 80% vs 50%, P<0.001), were more frequently based in England/United States (than in France/Germany/Italy) (78% vs 21%, P<0.001), had longer involvement in care of patients with AAV (≥ 15 years: 62% vs 37%, P=0.006), had less practice in using intermittent pulse therapy as the exclusive/predominant CYC administration scheme (62% vs 89%, P<0.001), and, as a rationale underpinning their mesna practice, had less adherence to local operational procedures (47% vs 73%, P=0.002) or (inter)national management guidelines for AAV (16% vs 49%, P<0.001). Never/occasional versus systematic use of mesna did not differ across medical specialties (5 categories, P=0.192) or healthcare settings (3 categories, P=0.437), and was not associated with prior experience of CYC-related urotoxic events (3 categories, P=0.495) or severe mesna toxicity issues (3 categories, P=0.957). The confidence that their practice reflected the best possible patient care did not differ between never/occasional and systematic mesna-prescribers (7-point Likert scale, P=0.794).Conclusion:Practice with regard to prescribing mesna in conjunction with CYC to treat AAV is heterogeneous, although systematic mesna use prevailed over never or occasional use. The decision to prescribe or not mesna may be based more on circumstantial than structural reasons.Disclosure of Interests:Lukas Joos: None declared, Solange Gonzalez Chiappe: None declared, Thomas Neumann Speakers bureau: GSK, Grant/research support from: Xifor, Alfred Mahr Speakers bureau: Amgen, Celgene, Roche, Chugai, Consultant of: Amgen, Celgene, Roche, Chugai

scholarly journals Novel late-stage radiosynthesis of 5-[18F]-trifluoromethyl-1,2,4-oxadiazole (TFMO) containing molecules for PET imaging

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nashaat Turkman ◽  
Daxing Liu ◽  
Isabella Pirola
Keyword(s):  
Late Stage ◽  
Histone Deacetylases ◽  
Radiochemical Purity ◽  
Radiochemical Yield ◽  
Single Step ◽  
The Novel ◽  
Molar Activity ◽  
The Central Nervous System ◽  
Class Iia Hdacs ◽  
18F Fluoride

AbstractSmall molecules that contain the (TFMO) moiety were reported to specifically inhibit the class-IIa histone deacetylases (HDACs), an important target in cancer and the disorders of the central nervous system (CNS). However, radiolabeling methods to incorporate the [18F]fluoride into the TFMO moiety are lacking. Herein, we report a novel late-stage incorporation of [18F]fluoride into the TFMO moiety in a single radiochemical step. In this approach the bromodifluoromethyl-1,2,4-oxadiazole was converted into [18F]TFMO via no-carrier-added bromine-[18F]fluoride exchange in a single step, thus producing the PET tracers with acceptable radiochemical yield (3–5%), high radiochemical purity (> 98%) and moderate molar activity of 0.33–0.49 GBq/umol (8.9–13.4 mCi/umol). We validated the utility of the novel radiochemical design by the radiosynthesis of [18F]TMP195, which is a known TFMO containing potent inhibitor of class-IIa HDACs.

scholarly journals Positron Emission Tomography (PET) Imaging of Multiple Myeloma in a Post-Treatment Setting

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 230
Author(s):  
Giulia Ferrarazzo ◽  
Silvia Chiola ◽  
Selene Capitanio ◽  
Maria Isabella Donegani ◽  
Alberto Miceli ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Multiple Myeloma ◽  
Fdg Pet ◽  
Therapy Monitoring ◽  
Emission Tomography ◽  
Clinical Value ◽  
Pet Tracers ◽  
Interpretation Criteria ◽  
Monitoring Therapy ◽  
Positron Emission

2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography/computed tomography (FDG PET/CT) has an established clinical value in the diagnosis and initial staging of multiple myeloma (MM). In the last ten years, a vast body of literature has shown that this tool can also be of high relevance for monitoring therapy responses, making it the recommended imaging approach in this field. Starting from the strengths and weaknesses of radiological imaging in MM, the present review aims to analyze FDG PET/CT’s current clinical value focusing on therapy response assessment and objective interpretation criteria for therapy monitoring. Given the potential occurrence of patients with MM showing non-FDG-avid bone disease, new opportunities can be provided by non-FDG PET tracers. Accordingly, the potential role of non-FDG PET tracers in this setting has also been discussed.

Taming trilostane: past and future

2019 ◽  
Vol 24 (9) ◽  
pp. 458-465
Author(s):  
Constance N White
Keyword(s):  
Adrenocorticotropic Hormone ◽  
Monitoring Tool ◽  
Acth Stimulation ◽  
Monitoring Therapy ◽  
Clinical Control ◽  
Cortisol Levels

A number of methods have been proposed for monitoring trilostane therapy for canine hyperadrenocorticism. Lack of consensus on timing and targets for adrenocorticotropic hormone (ACTH) stimulation testing, coupled with the fact that post-ACTH cortisol levels may not correlate well with clinical control, suggest that stimulation testing may not be as reliable a monitoring tool as initially thought. This article reviews developments in our understanding of the action, dosage, and monitoring of trilostane therapy of canine hyperadrenocorticism. Trilostane pharmacodynamics should be considered both in monitoring therapy and in tailoring dosage and frequency of administration.

scholarly journals The Quality of Life and Satisfaction with Continuous Glucose Monitoring Therapy in Children under 7 Years of Age with T1D Using the rtCGM System Integrated with Insulin Pump—A Caregivers Point of View

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3683
Author(s):  
Ewa Rusak ◽  
Natalia Ogarek ◽  
Karolina Wolicka ◽  
Anna Mrówka ◽  
Sebastian Seget ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Insulin Pump ◽  
Age Groups ◽  
Glucose Monitoring ◽  
Point Of View ◽  
Therapy Assessment ◽  
Monitoring Therapy ◽  
Original Survey

Quality of life (QoL) is an important parameter that affects the choice of therapy. Assessment of QoL and satisfaction with therapy using the rtCGM in children with T1D aged < 7 years was conducted. The study group consisted of 38 children with T1D aged < 7 years (34% aged 2–4, 66% aged 5–7 years), HbA1c: 6.53 ± 0.63%, duration of diabetes: 2.6 ± 1.6 years, treated with an rtCGM-augmented insulin pump for 1.92 ± 1.15 years. Two anonymous surveys were conducted: a. PedsQL3.0 diabetes standardized questionnaire—QoL assessment among age groups: 2–4/5–7 years. b. An original survey assessing the CGM use satisfaction. The mean scores in PedsQL3.0: communication 75%, worries 30%, treatment 70%, and problems associated with diabetes 65%. The QoL scale is: 0–19% very low, 20–39% low, 40–59% moderate, 60–79% high, 80–100% very high. The most frequently reported concerns were long-term diabetes complications and prick pain. Satisfaction with CGM use was high (68% in group aged 5–7 and 92% 2–4 years). Twenty-seven (71%) caregivers confirmed the positive effect of CGM on sleep. During the use of rtCGM a high quality of life was reported, and the quality of sleep in their caregivers was increased.

scholarly journals AB1087 DETECTING AXIAL AND PERIPHERAL NEW BONE FORMATION IN SPONDYLOARTHRITIS PATIENTS USING [18F]FLUORIDE PET-CT IMAGING

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1832.2-1833
Author(s):  
J. De Jongh ◽  
R. Hemke ◽  
G. C. J. Zwezerijnen ◽  
M. Yaqub ◽  
I. Van der Horst-Bruinsma ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Bone Formation ◽  
Ct Imaging ◽  
Whole Body ◽  
Therapeutic Effects ◽  
New Bone Formation ◽  
Research Support ◽  
Patella Tendon ◽  
Pet Ct ◽  
18F Fluoride

Background:Bone formation in spondyloarthritis (SpA) is presumably related to local enthesitis/peri-articular inflammation and ultimately may lead to functional limitation (1,2). X-rays only allow long-term monitoring of bone formation (≥2 years) (3). Imaging techniques that can visualize bone formation at an early stage would therefore be valuable. Positron Emission Tomography (PET) using [18F]Fluoride can visualize and quantify (early changes in) bone formation at molecular level (4).Objectives:To investigate the feasibility of [18F]Fluoride to assess new bone formation at axial and peripheral enthesial sites in SpA patients.Methods:Thus far, 5 of the total of 15 patients with clinically active ankylosing spondylitis (AS) (according to modified New York criteria and BASDAI ≥4) and 8 of the 25 patients with active psoriatic arthritis (PsA) (according to CASPAR criteria and ≥1 clinically active enthesitis) were included. Of each patient, a whole body [18F]Fluoride PET-CT scan was performed. All scans were visually judged and scored dichotomously by one reader (blinded for clinical data) for PET-positive lesions in the spine, peripheral enthesis sites and joints. Low dose CT was used for anatomical reference.Results:The study is ongoing, with whole body [18F]Fluoride PET-CT scans available in five AS patients and eight PsA patients. In 4/5 AS scans, at least (≥1) PET positive lesions were found in the cervical, thoracic and/or lumbar vertebrae. These were mainly found in anterior corners of vertebrae and bridging syndesmophytes (Fig. 1A). In all eight PsA patients, at least 1 PET positive lesion was visualized, projected either at the site of a tendon attachment (fascia plantaris, achilles- and patella tendon (Fig 1B)) or peri-articularly (in the ankle or wrist).Fig 1.[18F]Fluoride uptake in the cervical, thoracic and lumbar spine in a clinically active AS patient (A) and in the patella tendon of the right knee in a clinically active PsA patient (B)Conclusion:[18F]Fluoride PET uptake, reflecting new bone formation, can be visualized at heterogeneously distributed enthesis and (peri-)articular sites in AS- and PsA patients. The technique therefore is sensitive to visualize new bone formation and may reflect local disease activity. Additional scans will be collected and analyzed quantitatively, also after anti-TNF or Secukinumab treatment, to further investigate the applicability of [18F]Fluoride PET for monitoring of therapeutic effects on bone formation in SpA.References: :[1]Maksymowych WP, Mallon C, Morrow S, Shojania K, Olszynski WP, Wong RL, et al. Development and validation of the Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index. Ann Rheum Dis. 2009;68(6):948-53.[2]Rezvani A, Bodur H, Ataman S, Kaya T, Bugdayci DS, Demir SE, et al. Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis. Mod Rheumatol. 2014;24(4):651-6.[3]Rudwaleit M, Khan MA, Sieper J. The challenge of diagnosis and classification in early ankylosing spondylitis: do we need new criteria? Arthritis Rheum 2005;52:1000-8..[4]Bruijnen ST, Verweij NJF, van Duivenvoorde L, Bravenboer N, Baeten D, van Denderen JC, et al. [18F]Fluoride PET-CT imaging of bone formation in ankylosing spondylitis before and after 12 weeks of anti-TNF treatment. 2017.Acknowledgments:We thank EULAR Foreum, Pfizer and Novartis for financial support of this investigator initiated study.Disclosure of Interests:Jerney de Jongh: None declared, Robert Hemke: None declared, Gerben C.J. Zwezerijnen: None declared, Maqsood Yaqub: None declared, Irene van der Horst-Bruinsma Grant/research support from: AbbVie, Novartis, Eli Lilly, Bristol-Myers Squibb, MSD, Pfizer, UCB Pharma, Consultant of: AbbVie, Novartis, Eli Lilly, Bristol-Myers Squibb, MSD, Pfizer, UCB Pharma, Marleen G.H. van de Sande Grant/research support from: Novartis, Eli lily, UCB, Jansen, Consultant of: Abbvie, Novartis, Eli lily, MSD, Arno Van Kuijk: None declared, Irene Bultink: None declared, Lot Burgemeister: None declared, Nancy M.A. van Dillen: None declared, Alexandre Voskuyl: None declared, Conny J. van der Laken: None declared

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